Abstract:
Objective: To compare the effectiveness of four types of out-of-hours
emergency dental service, including both 'walk-in' and telephoneaccess
services.
Basic design Questionnaire survey of patients attending weekend
emergency dental services, with measurement of self-reported oral
health status and dental pain (at attendance and follow-up) and
retrospective judgements of change in oral health status.
Setting: Two health authorities in South Wales, UK.
Subjects: A total of 783 patients who completed questionnaires at
attendance, and 423 who completed follow-up questionnaires.
Results: For patients who saw a dentist there were no consistent
differences in the effectiveness of the four services, whether measured
as pain relief, oral health gain or using patients' retrospective transition
judgements about feeling better after their episode of emergency dental
care. The proportion of patients reporting no improvement (transition
j ernents), either an hour after or the day after seeing the dentist,
was surprisingly high (30-400/0 and 23-380/0 respectively). Although the
'rotas for all' - a telephone-access GDP-provided service for both
registered and unregistered patients - achieved both the highest
reductions in pain scores and the greatest improvements in dental
health status between attendance and follow-up, this effect may reflect
health gains due to care received after the episode of emergency dental
care.
Conclusions: Neither the setting where emergency dental patients are
seen, nor the type of dentist who sees them, appear to have any
significant effect on patient-reported health outcomes. Although
further exploration of the factors that predict poor pain relief or low
oral health gain is required, future research on these services should
focus on the process of care and accessibility.
